NYMC Faculty Publications

Comparison of Femtosecond Laser-Assisted Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty for Keratoconus

Author Type(s)

Faculty

DOI

10.1186/s12886-015-0140-x

Journal Title

BMC Ophthalmology

First Page

144

Last Page

144

Document Type

Article

Publication Date

10-27-2015

Department

Ophthalmology

Keywords

Adult, Anterior Eye Segment, Astigmatism, Cell Count, Corneal Endothelial Cell Loss, Corneal Transplantation, Endothelium, Corneal, Female, Graft Survival, Humans, Keratoconus, Keratoplasty, Penetrating, Laser Therapy, Male, Retrospective Studies, Tomography, Optical Coherence, Visual Acuity, Young Adult

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND: To compare outcomes of femtosecond laser-assisted deep anterior lamellar keratoplasty (FSL-DALK) and penetrating keratoplasty (FSL-PK) for the treatment of keratoconus.

METHODS: Twenty eight eyes underwent FSL-DALK (consisted of 12 eyes in the FSL-DALKa subgroup without baring the Descemet's membrane and 16 eyes in the FSL-DALKb subgroup baring the Descemet's membrane using big-bubble technique) were compared with 12 eyes that underwent FSL-PK for keratoconus. These patients underwent an ophthalmic examination preoperatively and 3, 6, 9, and 12 months postoperatively.

RESULTS: The postoperative BCVA in the FSL-PK group, and the FSL-DALKb subgroup were significantly better than that in the FSL-DALKa subgroup (P <  0.05), whereas no differences were found between the FSL-DALKb subgroup and the FSL-PK group (P > 0.05). There were no significant differences in the mean spherical equivalent (SE) and astigmatism between the FSL-DALK and the FSL-PK groups, nor between the subgroups of FSL-DALK during the follow-up period (P > 0.05). At the last follow-up, the mean endothelial cell loss in the FSL-DALK group (9.12 %) was significantly less than that in the FSL-PK group (20.79 %) (P <  0.001), while there was no difference between the FSL-DALKa (9.15 %) and the FSL-DALKb (9.10 %) subgroups (P = 0.15). The FSL-DALK group seemed to have fewer graft rejections (1/28 cases) than the FSL-PK group (2/12 cases), although Kaplan-Meier curve showed no significant difference between the two groups (P = 0.144).

CONCLUSIONS: In this retrospective study, the results suggested that FSL-DALKb gives better visual outcome, and FSL-DALKb is a better option for keratoconus whose endothelium is not compromised. However, larger and prospective studies are further required.

Link to Full Text

Share

COinS